Chilblains

Chilblains are reddish appearing swelling on the skin which are caused by the reaction of cold. The condition is also known as pernio and is a localised form of vasculitis. Chilblains are a painful abnormal reaction of the small blood vessels in the skin when exposed to cold temperatures. A chilblain is a small, red swelling on the skin which can be very itchy and gradually becomes very painful. Chilblains usually occur on the smaller toes but can occur on the finger, face and the nose.

Chilblains are more likely to develop in those with poor peripheral circulation. The elderly, sedentary, teenagers and people with medical conditions (such as anaemia) are most susceptible.They occur due to an abnormal reaction of the body to cold. A chilblain may also occur on a pressure bearing area such as a bunion. The cold causes constriction of the small blood vessels in the skin and if rewarming of the skin happens too rapidly, there is leakage of blood into the tissues as the blood vessels do not respond quickly enough to this rewarmin.

Symptoms of Chilblains

The symptoms of Chilblains include the following points:

• Possible secondary infection
• Ulceration, in severe cases.
• The lesion becomes increasingly painful.
• The lesion becomes very itchy.
• Patients may suffer from a burning sensation on their feet.
• A burning sensation on the skin
• Red, swollen patches
• In extreme cases the surface of the skin may break and an infection may develop
• Intense itching
• Dry skin, leading to splits and cracks

Causes of Chilblains

Chilblains is an abnormal reaction to cold. Elderly people with a poor circulation are at a greater risk. Young adults who work outdoors or in cold conditions, such as butchers, are also at risk. If the skin is chilled and then followed by too rapid warming such as a gas fire, a chilblain may develop. Damp living conditions can also be a contributing factor. A familial tendency.

Peripheral vascular disease due to diabetes, smoking, hyperlipidaemia. Poor nutrition e.g. anorexia nervosa. Hormonal changes: chilblains can improve during pregnancy. Connective tissue disease. Bone marrow disorders The sudden onset of very cold water on the skin can also lead to a chilblain. Other contributing factors include dietary, hormonal imbalance and people who suffer from anemia.

Home Treatment and other treatment options for Chilblains

The following measures may be helpful.

• Exercise vigourously before going outside
• Wear cotton-lined waterproof gloves for wet work
• Apply sunscreen to exposed skin even on dull days
• Insulated and heated home and workplace stop up all draughts
• Warm clothing especially gloves, thick woollen socks and comfortable protective footwear. Keep the head and neck warm with hat and scarf
• Before going outside, soak hands in warm water for several minutes to warm hands through then dry thoroughly
• Antibiotic ointment or oral antibiotics may be necessary for secondary infection.
• Take vasodilator medication such as nifedipine prescribed before the onset of cold weather and taken throughout winter. Side effects include flushing and headache.
• A potent topical steroid applied accurately for a few days may relieve itch and swelling.

Prevention tips

Chilblains can be prevented by saving yourself from the main causes of it: Insulated and heated home and workplace stop up all draughts Warm clothing especially gloves, thick woollen socks and comfortable protective footwear. Keep the head and neck warm with hat and scarf. Before going outside, soak hands in warm water for several minutes to warm hands through then dry thoroughly. Exercise vigourously before going outside.

Some other prevention tips for Chilblains include:

• Wear cotton-lined waterproof gloves for wet work
• Take vasodilator medication such as nifedipine prescribed before the onset of cold weather and taken throughout winter. Side effects include flushing and headache.
• Apply sunscreen to exposed skin even on dull days